Desmond Fialkosky is a dedicated Physician Assistant committed to the “whole-body” wellness of Montanans. A Havre native, Desmond’s clinical approach is rooted in the belief that mental health is inseparable from physical vitality. By blending his background in Integrated Human Biology with advanced psychiatric training, he helps patients navigate the complexities of mental health with a focus on sustainable, long-term recovery and high-quality clinical care.
Desmond earned his undergraduate degree from Bastyr University before returning to Montana to complete his Master’s in Physician Assistant Studies at Rocky Mountain College. His path to psychiatry was shaped by his time in the ICU at Billings Clinic, where he witnessed firsthand the critical intersection of acute medical care and emotional resilience. Today, he holds a Certificate of Added Qualifications (CAQ) in Psychiatry, a distinction that highlights his specialized expertise and clinical mastery in the field.
Desmond’s practice is built on a deep understanding of the biological systems that drive mental wellness. With a degree in Integrated Human Biology, he evaluates psychiatric symptoms through a physiological lens, ensuring that every treatment plan addresses the underlying biological needs of the patient. This science-driven perspective allows him to provide care that is as precise as it is compassionate.
Informed by his experience in the Intensive Care Unit, Desmond prioritizes building strong, trust-based relationships with his patients. He understands that true healing happens when a provider listens as closely as they treat. At Montana Psychiatry, he focuses on creating a safe, collaborative environment where patients feel empowered to take an active role in their mental health journey and overall wellness.
A true Montanan at heart, Desmond is passionate about improving the quality of life across the state. His advocacy for mental health is fueled by his connection to the local community and the rugged landscapes he calls home. Outside of the clinic, you can find him embracing the Montana lifestyle, hiking in the mountains, fishing, hunting, and spending quality time with his friends and family.
We offer virtual programs for adults, teens, and children who need more than weekly therapy, with family support built in. Every care plan is individually designed to treat the whole person—not just a diagnosis.
Find your balance with expert psychiatric medication management. Our mental health specialists provide personalized treatment plans for ADHD, anxiety, and depression. We focus on evidence-based care and regular monitoring to ensure your wellness journey aligns with your lifestyle.
Discover a new path for treatment-resistant depression. We offer FDA-approved esketamine nasal spray for those who haven’t found success with traditional antidepressants, providing rapid-acting support and in-office monitoring in a safe, professional setting.
Non-invasive relief for treatment-resistant depression. FDA-approved TMS uses magnetic pulses to stimulate mood centers without medication side effects. Reclaim your mental health with this drug-free, no-downtime treatment.
Experience rapid relief for depression and PTSD. Our clinical ketamine infusions target neural pathways to provide breakthroughs where traditional meds fail. Start your journey to healing in a safe, medically supervised environment.
Skip the commute with secure virtual care. Our HIPAA-compliant telehealth platform offers insurance-friendly psychiatry and therapy sessions from home. Professional mental health support is now convenient, private, and just a click away.
3737 Grand Avenue, Suite 6
Billings, MT – 59102
Tel : 406-839-2985
Therapy Office
517 S 24th St. W. Unit C3
Billings, MT – 59102
Tel : 406-839-2985
Tel : 406-551-8001
